Apostolo Joao, Holland Carol, O'Connell Matthew D L, Feeney Joanne, Tabares-Seisdedos Rafael, Tadros George, Campos Elzbieta, Santos Nadine, Robertson Deirdre A, Marcucci Maura, Varela-Nieto Isabel, Crespo-Facorro Benedicto, Vieta Eduard, Navarro-Pardo Esperanza, Selva-Vera Gabriel, Balanzá-Martínez Vicent, Cano Antonio
Portugal Centre for Evidence Based Practice, Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Portugal.
Aston Research Centre for Healthy Ageing, Aston University, Birmingham, UK.
Maturitas. 2016 Jan;83:83-93. doi: 10.1016/j.maturitas.2015.10.008. Epub 2015 Oct 22.
Mild cognitive impairment (MCI) is a term used to describe a level of decline in cognition which is seen as an intermediate stage between normal ageing and dementia, and which many consider to be a prodromal stage of neurodegeneration that may become dementia. That is, it is perceived as a high risk level of cognitive change. The increasing burden of dementia in our society, but also our increasing understanding of its risk factors and potential interventions, require diligent management of MCI in order to find strategies that produce effective prevention of dementia.
To update knowledge regarding mild cognitive impairment, and to bring together and appraise evidence about the main features of clinical interest: definitions, prevalence and stability, risk factors, screening, and management and intervention.
Literature review and consensus of expert opinion.
MCI describes a level of impairment in which deteriorating cognitive functions still allow for reasonable independent living, including some compensatory strategies. While there is evidence for some early risk factors, there is still a need to more precisely delineate and distinguish early manifestations of frank dementia from cognitive impairment that is less likely to progress to dementia, and furthermore to develop improved prospective evidence for positive response to intervention. An important limitation derives from the scarcity of studies that take MCI as an endpoint. Strategies for effective management suffer from the same limitation, since most studies have focused on dementia. Behavioural changes may represent the most cost-effective approach.
轻度认知障碍(MCI)是一个用于描述认知能力下降程度的术语,它被视为正常衰老与痴呆之间的中间阶段,许多人认为它是可能发展为痴呆的神经退行性变的前驱阶段。也就是说,它被视为认知变化的高风险水平。我们社会中痴呆负担的日益加重,以及我们对其风险因素和潜在干预措施的日益了解,都需要对MCI进行认真管理,以便找到有效预防痴呆的策略。
更新关于轻度认知障碍的知识,并汇集和评估有关临床关注的主要特征的证据:定义、患病率和稳定性、风险因素、筛查以及管理和干预。
文献综述和专家意见共识。
MCI描述了一种损害程度,在此程度下,认知功能的恶化仍允许进行合理的独立生活,包括一些代偿策略。虽然有证据表明存在一些早期风险因素,但仍需要更精确地界定和区分明显痴呆的早期表现与不太可能发展为痴呆的认知障碍,此外还需要为干预的积极反应提供更好的前瞻性证据。一个重要的局限性源于将MCI作为终点的研究稀缺。有效的管理策略也存在同样的局限性,因为大多数研究都集中在痴呆方面。行为改变可能是最具成本效益的方法。